Tuesday, March 05, 2013

Nicholson should not resign, he should be put on trial

If a private company were
responsible for the deaths of up to 1,200 people there would be a national
outcry and demands to jail those responsible.

Yet, after no fewer than
five investigations into what happened at StaffordHospital,
no individual has received so much as a slapped wrist.

How can this be?

The police have begun an
investigation into what must be the biggest scandal in the history of the NHS.

Years after the event, they
have finally stirred themselves.

Matthew Ellis, the police
and crime commissioner for Staffordshire, claims they have “information not in
the public domain”.

How they came by it should
itself be the subject of a public inquiry.

Why do the police have
information which has not been declared even to tribunals set up by the
Government?
The latest inquiry by Robert Francis QC uncovered years of abuse and neglect at
the hospital leading to the unnecessary deaths of between 400 and 1,200 people.

These aren’t statistics,
they’re individuals who placed their trust in a system which ended up killing
them – horrific for the victims and their loved ones.

This isn’t a case of an
individual nurse or doctor. Mr Francis concludes the failings go right to the
top of the health service.

The police investigation is
no doubt being staged mainly for political reasons.

Everyone from David Cameron
down believes scapegoats must be found, heads must roll and someone should pay.
He says: “One of the important points about the Mid-Staffordshire inquiry is to
make sure, when a failure like this takes place, there is proper
accountability.

"In the report, you can
see exactly what happened to the people who were involved. Some of them were allowed to retire, some were allowed to move within the
health service. There wasn't proper accountability, there wasn't proper consequences
and that is not acceptable."

Actually Dave, some of them
didn’t move or retire, they were promoted, given more money, more power and
more responsibility.

And it is not too late to
insist on “proper accountability and proper consequences”.

It’s highly likely the
police will content themselves with digging out a few especially shocking cases
of neglect involving a heartless nurse or two.

But let’s hope they are
mounting a major prosecution of people at the very top of the NHS on a charge
of corporate manslaughter.

The health service as a
whole is guilty of causing unnecessary deaths as a result of several layers of
mismanagement, indifference and neglect.

The doctors and consultants
must take much of the blame. They saw what was going on but “kept their heads
down”, according to Mr Francis.

But the real defendants
should be among the £200,000-a-year bureaucrats in whom we mistakenly place our
trust.

Chief among these is Sir
David Nicholson.

In 2003 he was Chief Executive of
Birmingham and The Black Country Strategic Health Authority. In 2005 he took on
Shropshire and Staffordshire as well, at about the time people started
needlessly dying at StaffordHospital.

He did so well in the West Midlands he became chief executive of the entire
NHS in England
in 2006.

He is paid over £200,000 a year, claims £50,000 a year in expenses and
enjoys benefits-in-kind worth £37,600.

There haven’t been any successful corporate manslaughter prosecutions
against individuals.

But the charge was introduced after a series of disasters including the
1987 “Herald of Free Enterprise” tragedy when 193 passengers and crew died and the
1999 Ladbroke Grove rail crash which killed 31 people.

Corporate manslaughter cases usually end up in large fines for the
businesses involved.

There’s absolutely no point in similar penalties for the NHS because the
whole case would involve the re-cycling of our money.

But where does the buck stop in a scandal like StaffordHospital?
Surely it must stop somewhere.

Or is the health service such a rambling and unwieldy organisation that
officially nobody can be held to account for anything? Is the NHS so big it is
always someone else’s fault?

That cannot be acceptable.

We rightly condemn top bankers for bringing the nation to the brink of
bankruptcy and some of them, like Sir Fred Goodwin of RBS, even had to quit
(albeit with hefty pay-offs).

That was only money. When it comes to lives, it seems no individual is to
blame – just a “culture”.

The Francis report says:
“The negative aspects of
culture in the system were identified as including: lack of openness to
criticism; lack of consideration for patients; defensiveness; looking inwards
not outwards; secrecy; misplaced assumptions about the judgements and actions
of others; acceptance of poor standards; a failure to put the patient first in
everything that is done.”

And it’s clear the culture is dictated
from the top – Sir David’s department “has not always put patients first”.

So where does the buck stop? Who sets the tone for an organisation? Who is
responsible for its corporate culture?

It’s time Sir David was made to face up to his personal responsibility for
this national tragedy. But he’s probably so lost in NHS bureaucracy he thinks
culture is something they grow in a test tube.